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University of Toronto Scarborough
International Development Studies
Anne- Emanuelle Birn

Chapter 2 Key Questions: - When and why did governments, wealthy interests, and the public become concerned with the spread of disease across borders and territories? o As rival leaders fought for power, and merchants became interested in the riches and resources of far away places, travel and commerce gradually increased, o Towns of late medieval Europe had far lower standards of water supply, sanitation, n hygiene than ancient civilizations (they were excellent candidates for outbreaks of epidemic) o Middle Ages were bracketed by 2 gr8 outbreaks of plague: The first pandemic, Plague of Justinian struck in 542 CE (decimated populations from Asia to Ireland The second, The great Black Death of 14 century , the most destruction epidemic in the history of mankind o Plagues suspected spread thru human contact led to the earliest attempts at international disease control - How were theses concerns addressed? o Believed that plague was spread thru human contact, and since plague was introduced by ships, the city-state of Venice in 1348 adopted a 40-day detention period entering vessels after which the disease was believed to remit o This practice of quarantine was minimally effective in stopping plague - What motivated the rise of international health agencies, and what influenced their development? o Black Deaths initial appearance preceded the formation of nation-states, sanitary efforts were adopted and implemented by municipal authorities, one at a time, rather than by national governments o Following the first plague, many cities established plague boards, or even permanent public health boards, charged with imposing the necessary measures at times of outbreak Learning Points - International health was (and is) interwined with social, political, and economic factors - The rise of imperialism, industrialization, global capitalism, and commerce played a critical role in shaping worldwide patterns of health and disease and spurring the formation of international health measures and institutions - International health institutions were formed for a variety of complex motives, far beyond shared health needs Chapter 3 Key Questions: What is International Health? What shapes the organization of international health? o 3 key sets of organizations were established in the wake of WWII (1939-1945) which have profoundly shaped international health ideas, activities, and developments: 1. WHO and other UN agencies 2. World Bank and related multilateral financial institutions 3. Bilateral aid and development organizations based in industrialized countries - How have the various agencies and actors in international health and their activities evolved over the past half-century? o Relations among the imperial blocks changed fundamentally after WW2, as explicit colonialism was replaced with a less politically volatile and less costly division of world power. o As imperial system gave way to a new political and economic order, the international health field and its key institutes were shaped by two factors: The context of the Cold war- the political and ideological contest between Western capitalism and Soviet communism. The paradigm of economic development which was perceived as the sole path of progress for countries in Asia, Africa, and Latin America. Current Snapshot of International Health Actors, Agencies, and Programs - Who are the major players in international health? o Multilateral agencies with a health focus o WHO
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